Antimicrobial Resistance Situation of Healthcare-associated and Community-Acquired in Patients with Bloodstream Infections, Nopparat Rajathanee Hospital, 2018-2019
DOI:
https://doi.org/10.14456/jdms.2023.20Keywords:
Healthcare-associated bloodstream infection (HA-BSI), Community-acquired bloodstream infection (CA-BSI), Antimicrobial resistance (AMR)Abstract
Background: Antimicrobial resistance (AMR) is primarily found in hospitals and tends to steadily increase forvarious reasons. The World Health Organization prioritizes the the ESKAPE bacteria group, which includes Enterococcusfaecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa,and Enterobacter spp. These bacteria are commonly found in hospitals for bloodstream infections (BSI), which can be community-acquired bloodstream infection (CA-BSI) from home or community, or healthcare-associatedbloodstream infections (HA-BSI) from hospitals. At present, there are no studies on community-acquired antimicrobialresistance compared to that in hospitals. Objective: The purpose of this research was to study the situation of ESKAPE bacteria antimicrobial resistance organisms identified in HA–BSI and CA-BSI patients, in order to developan AMR surveillance system, plan for appropriate treatment, care, and discharge for these patients. Methods: Thisretrospective study reviewed medical records of all hospitalized patients with at least one positive blood culturefrom recognized pathogens, from January 2018 to December 2019. The medical records were reviewed by infectioncontrol nurses (ICNs) using a standardized case report form. Results: 1,806 sample cases were analyzed, with gramnegative found in 77.8% of cases, compared to gram-positive bacteria. The ESKAPE bacteria antimicrobial resistanceorganisms were K. pneumoniae 40.6% (404/498), S. aureus 32.9% (164/498), and A. baumannii 10.0% (50/498),respectively. HA-BSI was found to have 18.4% MDR, 38.9% CRE, and 20.0%. VRE CA-BSI excluding POA was found tohave an MDR rate of 6.0% and CRE of 2.8%, while POA in CA-BSI had an MDR rate of 16.7% and CRE rate of 9.1%. Conclusion: Antimicrobial resistance is prevalent in both HA-BSI and CA-BSI; thus, it should be managed both inhospitals and communities, which includes people, animals, food, and agriculture, following the environment forone health model since there are many factors involved.
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